Changes Over Time in Treatment Patterns and Health Care Resource Utilization in Patients with COPD: Real-World Data from a Large Health Maintenance Organization

• •During 2001-2020 the rate of new COPD cases decreased while prevalence increased • •Performance and/or documentation of spirometry was inadequate in COPD patients • •COPD patients showed higher comorbidity than a matched control population • •Half of the COPD patients were receiving no appropriate maintenance inhaler therapy • •During 2015-2021 LAMA use (alone/ combined) increased and ICS-LABA use decreased •During 2001-2020 the rate of new COPD cases decreased while prevalence increased •Performance and/or documentation of spirometry was inadequate in COPD patients •COPD patients showed higher comorbidity than a matched control population •Half of the COPD patients were receiving no appropriate maintenance inhaler therapy •During 2015-2021 LAMA use (alone/ combined) increased and ICS-LABA use decreased Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide and is associated with increased costs. To assess treatment patterns, comorbidities and health care resource utilization (HCRU) in a large COPD patient population, with specific attention to changes over time. A retrospective study of patients with COPD, using the computerized database of a large health maintenance organization. Treatment patterns with inhaled drug (corticosteroids ICS, long-acting beta agonists LABA and long-acting muscarinic antagonists LAMA) were analyzed during 2015-2021. Prevalent patients with COPD in 2021 were matched with patients from the general population. We identified 43, 778 patients with a first (new) diagnosis of COPD during 2001-2020. The mean age was 60. 6 years (±12. 0), 56. 6% were males and 55. 2% were diagnosed by a pulmonologist. Spirometry tests results were available in 21. 4% of patients. The proportion of patients treated with any inhaled drugs was relatively unchanged between 2015-2021 (48. 6-51. 6%). ICS with LABA was the most frequently used treatment but decreased from 50. 3% in 2015 to 43. 6% in 2021, while triple therapy increased, from 18. 6% in 2015 to 25. 4% in 2021. Compared to the general population, patients with COPD were more likely to be smokers, obese, have more comorbidities and increased HCRU. Our study provides real-world data on clinical features, treatment patterns and co-morbidities in COPD patients and shows changes in trends over time. This data may be useful to identify patients with COPD, to allow for improved targeted interventions, improved guideline-based treatment choices, and improved COPD control.